Alcoholic fatty liver disease

Alcoholic fatty liver disease (AFLD) is a frequent disease in people who regularly consume large amounts of alcohol. In most cases, they do not realize that they have AFLD. Read on to find out why this initially harmless condition should be taken seriously.

At a glance

  • Alcoholic fatty liver disease is initially harmless but can be a precursor of severe cirrhosis of the liver, i.e., a serious case of scarring of the liver.
  • AFLD usually has no symptoms.
  • In addition to regular, heavy alcohol consumption, there are a number of other risk factors, such as being overweight.
  • Around 90 percent of people who drink large volumes of alcohol regularly will develop AFLD.
  • AFLD can be reversed if alcohol consumption is stopped. 

Note: The information in this article cannot and should not replace a medical consultation and must not be used for self-diagnosis or treatment.

Bottle opener being used to open a beer bottle.

What is alcoholic fatty liver disease?

With alcoholic fatty liver disease (AFLD), increasing amounts of fat are stored in the cells of the liver. AFLD is caused by regular, heavy consumption of alcohol. While AFLD is initially harmless, it can develop into serious diseases, such as fatty inflammation of the liver (steatohepatitis) or cirrhosis of the liver.

Provided that long-term damage has not already been done, AFLD can disappear naturally if the individual stops consuming alcohol. If the person is also suffering from alcohol dependence, this will need to be treated.

What causes fatty liver disease?

This video explains how fatty liver disease develops and what symptoms may occur.

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What are the symptoms alcoholic fatty liver disease?

Many people with AFLD are not even aware that they have this illness. However, some experience symptoms such as a loss of appetite, nausea, and vomiting. 

What causes alcoholic fatty liver disease?

Alcohol is broken down in the liver. Consuming large amounts of alcohol can impair liver function and destroy or alter liver cells. In addition, fatty acids are produced when alcohol is broken down, which are stored in the liver. If large volumes of alcohol are consumed on a regular basis, a large amount of fat may accumulate in the liver.

Consuming large amounts of alcohol can impair liver function and destroy or alter cells.

Binge drinking also increases the risk of developing a fatty liver. Binge drinking refers to the consumption of a large volume of alcohol within a small amount of time – roughly 1.25 liters of beer or 0.6 liters of wine for men, and 1 liter of beer or 0.5 liters of wine for women.

What factors increase the likelihood of developing alcoholic fatty liver disease?

In addition to excessive alcohol consumption, the following factors also increase the risk of developing a fatty liver: 

Fatty liver also develops more rapidly in women than men. 

Interesting fact: According to the German Center for Addiction Issues (Deutsche Hauptstelle für Suchtfragen, DHS), the risk of developing alcohol-related diseases has been shown to be increased in women who consume more than 12 grams of pure alcohol daily and in men who drink more than 24 grams daily. 12 grams of alcohol is equivalent to one small beer (0.3 liters) or a small glass of wine (0.125 liters), for example. 

How common is alcoholic fatty liver disease?

No accurate figures are available to indicate how common AFLD is because this illness almost always develops without any symptoms. However, studies suggest that approximately 90 percent of those who drink large quantities of alcohol over an extended period will develop fatty liver disease. For a man, this would be equivalent to two bottles of beer or more per day.

How does alcoholic fatty liver disease progress?

If a person with AFLD completely abstains from drinking alcohol, the change in the liver is quickly reversed.

AFLD is the mildest alcohol-related disease of the liver. Having AFLD increases the risk of developing fatty inflammation of the liver and, later, cirrhosis of the liver – a serious disease that can be fatal.

How is alcoholic fatty liver disease diagnosed?

Various findings can indicate the presence of AFLD. These include:

  • a palpably enlarge liver
  • an increased level of a specific liver enzyme in the blood

If there is reason to suspect fatty liver disease, this can be verified in most cases using imaging techniques, such as an ultrasound scan. Taking a biopsy (a tissue sample) is rarely necessary.

To clearly distinguish between non-alcoholic fatty liver disease (NAFLD) and alcoholic fatty liver disease (AFLD), doctors will also find out from the patients exactly how much alcohol they consume and how often.

How can alcoholic fatty liver disease be treated?

The only treatment for alcoholic fatty liver disease is to abstain from drinking alcohol. With total abstention, a full recovery is possible.

The only treatment for alcoholic fatty liver disease is to abstain from alcohol. A full recovery is possible provided abstention is total.

If alcohol dependence is diagnosed in addition to AFLD, it is essential that this dependence be treated. 

As heavy alcohol consumption is frequently associated with nutrient deficiency, it is recommended that the patient adopt a balanced, nutrient-rich diet.

Where can I turn to for help with alcohol-related problems?

The Federal Center for Health Education (Bundeszentrale für gesundheitliche Aufklärung – BZgA) provides information about managing alcohol consumption and on self-help options on their (“know your limit”) website. Anyone who would like to find out if their alcohol consumption is excessive can take a self-test.

For detailed information, including options for people who have a loved one with alcohol issues, visit

In cooperation with the Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen – IQWiG).

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